Nebulizers are devices that generate aerosols from liquid medications to deliver drugs directly to the lungs. They work by using venturi effect to draw up liquid from a reservoir and break it into small droplets for inhalation. Common types include pneumatic jet, ultrasonic, and vibrating mesh nebulizers. Nebulizers are useful for patients who cannot coordinate inhalation from other devices or require high doses of bronchodilators. The procedure involves assessing the patient's need, selecting a delivery method, loading the medication, and coaching slow inhalation until treatment is complete.

1. NEBULIZER
DR.KRISHNA GOHIL (PT)

2. WHAT IS THE NEBULIZER.???
• Nebulizers are devices generate aerosols from solutions.
• Aerosol: A substance enclosed under pressure and released as a fine spry by means of
propellant gas.
• Sterile liquid is converted into an aerosol, whose droplets are small enough to navigate
the nasal passages and vocal cords, and reach the airways.
• Nebulizers used for delivering drugs.

3. WHAT IS THE NEBULIZER.???
• Some patients with severe reversible airways obstruction, require larger doses of a
bronchodilator.
• If asthma symptoms become severe, inspiratory airflow may become limited to such
an extent that the contents of a MDI (metered-dose inhalers) cannot be inhaled
adequately.
• With a nebulizer, a high-velocity jet of air or oxygen sucks liquid up a tube and the
liquid is broken into tiny particles which are inhaled and deposited in the lungs

4. DEFINITION
• A nebulizer is a device used to administer
medication in the form of a mist inhaled into
the lungs.
ELLEN HILLEGASS, ESSENTIAL OF CARDIOPULMONARY PHYSICAL THERAPY, 3RD EDITION.

5. • Work on venturi effect:
• The venturi effect is the reduction in fluid pressure that results when a fluid flows
through a constricted section (or choke) of a pipe
• Stream of gas is passed through a small hole it creates a lower pressure as it emerges
from that hole

6. • In Nebulizer
• Small tube, with one end immersed in bronchodilator
solution and other end near the area of low pressure
• Consequently the liquid is drawn up the tube and it is
then pushed on to a baffle, which splits the liquid into
particle

7. PARTS OF NEBULIZER

8. TYPES
PNEUMATIC JET NEBULIZER
• SMALL VOLUME JET NEBULIZER
• LARGE VOLUME JET NEBULIZER
ULTRASONIC NEBULIZER (USN)
VIBRATING MESH NEBULIZER (VMN)

9. PNEUMATIC JET NEBULIZER
• GAS-POWERED JET NEBULIZERS HAVE BEEN IN CLINICAL USE FOR LONGER
THAN 100 YEARS.
• MOST MODERN JET NEBULIZERS ARE POWERED BY HIGH-PRESSURE AIR OR
OXYGEN (O2) PROVIDED BY A PORTABLE COMPRESSOR, COMPRESSED GAS
CYLINDER.
• SMALL VOLUME JET NEBULIZER
• IT CONTAINS 5 TO 20 ML OF MEDICINES.
• LARGE VOLUME JET NEBULIZER
• IT CONTAINS UP TO 200 ML OF MEDICINES.

10. PNEUMATIC JET NEBULIZER

11. PNEUMATIC JET NEBULIZER
• GAS STREAM OPENING OF A CAPILLARY TUBE IMMERSED IN SOLUTION
• PRODUCES LOW LATERAL PRESSURE AT THE OUTLET
• HIGH JET VELOCITY DRAWS THE LIQUID UP TO CAPILLARY TUBE AND INTO THE GAS
STREAM,
• SHEARED INTO FILAMENTS OF LIQUID THAT BREAK UP INTO DROPLETS.
• PRODUCES SPRAY AEROSOL WITH DROPLETS RANGING FROM 0.1 TO 500µm.

12. ULTRASONIC NEBULIZER
• USN USES A PIEZOELECTRIC CRYSTAL TO GENERATE AN AEROSOL
• CAPABLE TO CREATES AEROSOL OF (0.2 TO 1.0 ML/MINS)
• HIGHER AEROSOL DENSITIES THAN CONVENTIONAL JET NEBULIZERS.
• PIEZOELECTRIC CRYSTAL GENERATE AN AEROSOL
• CRYSTAL TRANSDUCER CONVERTS AN ELECTRICAL SIGNAL INTO HIGH-FREQUENCY (1.2-
TO 2.4-MHZ) ACOUSTIC VIBRATION
• THEY DISRUPT SURFACE AND CREATE OSCILLATION WAVES.

13. ULTRASONIC NEBULIZER
• OSCILLATION WAVES FORM A STANDING
WAVE
• GENERATES DROPLETS
• BREAK FREE AS FINE AEROSOL PARTICLES

14. VIBRATING MESH NEBULIZER
• IN THIS TECHNOLOGY A MESH OR MEMBRANE WITH 1000-7000 LASER DRILLED HOLES
VIBRATION AT THE TOP OF THE LIQUID RESERVOIR, AND THEREBY PRESSURES OUT A
MIST OF VERY FINE DROPLETS THROUGH THE HOLES.
• THE HIGH NEBULIZATION CAPACITY (>0.25ML/MIN) DEVICE OFFERS SHORT
INHALATION TIME.

15. VIBRATING MESH NEBULIZER

16. PROCEDURE
• 1. ASSESS THE PATIENT FOR NEED (CLINICAL SIGNS AND SYMPTOMS, BREATH SOUNDS,
PEAK FLOW, %FEV1).
• 2. SELECT MASK OR MOUTHPIECE DELIVERY (NOSE CLIPS MAY BE NEEDED WITH
MOUTHPIECE).
• 3. USE CONSERVING SYSTEM (THUMB PORT, BREATH ACTUATOR, OR RESERVOIR) IF
INDICATED.
• 4. PLACE DRUG IN THE NEBULIZER. IF USING A MULTIDOSE VIAL, ADD SALINE TO
APPROVED DOSE VOLUME (PER DRUG LABEL).
• 5. SET GAS FLOW TO NEBULIZER AT 6 TO 10 L/MIN (PER MANUFACTURER LABEL).

17. PROCEDURE
• 6. COACH PATIENT TO BREATHE SLOWLY THROUGH THE MOUTH AT NORMAL VT.
• 7. CONTINUE TREATMENT UNTIL NEBULIZER BEGINS TO SPUTTER.
• 8. RINSE THE NEBULIZER WITH STERILE WATER AND AIR DRY, OR DISCARD, BETWEEN
TREATMENTS.
• 9. MONITOR PATIENT FOR ADVERSE RESPONSE.
• 10. ASSESS OUTCOME (CHANGE IN PEAK FLOW, %FEV1).

18. METHOD OF APPLICATION
• THE BRONCHODILATORS SHOULD BE DILUTED WITH A SOLUTION OF
SODIUM CHLORIDE, (NS) ITSELF A MILD BRONCHODILATOR ,
• TO MAKE 4ML
• THIS AMOUNT DELIVERS THE MAXIMUM DRUG WITHOUT AN
UNNECESSARY LENGTH OF TIME FOR THE PATIENT AND THE RESIDUAL
LIQUID IS NOT PURELY DRUG
• FOR E.G.
• 1 ML SALBUTAMOL WITH 3ML SALINE OR
• 2 ML OR 2 ML IPRATROPIUM BROMIDE WITH 2 ML SALINE
• IF BOTH DRUGS ARE PRESCRIBED TOGETHER THEY CAN BE GIVEN TOGETHER

19. • SOME PT WILL REQUIRE INHALED ANTIBIOTIC OR ANTIFUNGALAGENTS.
• AS THESE DRUG ARE THICKER THAN BRONCHODILATOR IT IS IMPORTANT TO HAVE A
POWERFUL COMPRESSOR TO DRIVE NEBULIZER.
• NEBULIZER MUST HAVE A MOUTHPIECE AND A ONE WAY VALVE ATTACHED TO A
PIECE OF WIDE BORE TUBING WHICH MUST BE PLACED LEADING OUT OF THE WINDOW

20. • IF ANTIBIOTIC OR ANTIFUNGAL
DRUGS ARE ALLOWED TO CIRCULATE
IN THE ROOM NOT ONLY WILL THE
ORGANISM BECOME RESISTANT TO
THEM, DRUGS SUCH AS
CERBENICILLIN ALSO DAMAGE THE
SURFACE OF FURNITURE

21. ADVANTAGE AND DISADVANTAGE

22. Thank
you…